The Food and Drug Administration (FDA) will hold a public meeting on 16 September 2008 to discuss the safety of bisphenol A (BPA), a chemical found in baby bottles and other plastic products. The FDA meeting will focus on questions raised in a draft report from the National Toxicology Program within the US National Institutes of Health.

The report expresses concern that BPA could cause neural and behavioral problems in fetuses, infants and children. BPA is used in polycarbonate bottles, including baby bottles, water bottles and the lining of cans (including infant formula). It has been the subject of one, two, three, four, five articles in baby gooroo.

If you’d like to voice your concerns, the FDA meeting will be held from 9:00 am to 3:30 pm at the Hilton Washington, Washington DC/Rockville Executive Meeting Center, Plaza Ballroom, 1750 Rockville Pike, Rockville, MD 20852. For more information about the go to the Federal Register.

One final thought … even if the amount found in bottles and cans is deemed safe, if the chemical has the potential to harm fetuses, infants and young children, what parent would want to risk using it?

That U.S. breastfeeding rates vary significantly from state to state is well known. What is less apparent (and the subject of a recent analysis) is why.

Western and northwestern states consistently boast the highest breastfeeding rates (duration as well as exclusivity), while southern and southeastern states lag well behind. Studies show that demographic and socioeconomic characteristics such as increasing maternal age, education, income, non-Hispanic White race, being foreign born, and being a non-smoker are associated with higher rates of breastfeeding.

In an effort to determine which (if any) of the characteristics account for the state to state differences, Michael Kogan, PhD and colleagues conducted a multivariate analysis. Data was taken from the National Survey of Children’s Health (NSCH), a nationally representative cross-sectional study of more than 100,000 children ages newborn to 18 years. The NCSH survey was conducted by telephone in all 50 states and the District of Columbia from January 2003 through July 2004. The person who knew the child best (mother, father or grandparent) was asked to participate in the survey.

For the purpose of Kogan’s study, participants were limited to children between the ages of 6 and 71 months (a total of 33,121 children). Two outcome measures were examined: (1) whether the child was ever breastfed and (2) whether the child was breastfed for at least 6 months.

The variables used in the analysis included:

• Family’s poverty level
• Child’s race/ethnicity
• Child’s gender
• Family structure
• Primary language spoken in the home
• Nativity status (child or parents foreign born)
• Smoker in the household
• Exercise behavior of mother
• General health (physical and mental) of mother

An added feature of the study was a look at whether state breastfeeding legislation is associated with breastfeeding rates.

Location, location, location
After adjusting for all the variables, where a child lived still had a strong association with whether he/she was breastfed and for how long. But before you pack up your kids, pets, and possessions, consider that a woman’s decision to breastfeed (or not) is influenced by a multitude of factors, key among them being the culture in which she lives.

In those states with more than one piece of breastfeeding promotion legislation, more children (76 percent) were breastfeed, compared to states with one or no pieces of legislation (63.7 percent). Additional research is needed to better understand the association between breastfeeding legislation and breastfeeding rates. One theory is that states with multiple pieces of breastfeeding legislation exemplify cultures in which breastfeeding is valued and supported.

“We can’t tell whether the legislation affected breastfeeding practices or whether the culture in the state was such that it influenced the legislature to promote breastfeeding legislation,” said Dr. Kogan.

credits: iStockphoto

By Nancy Bowers, BSN, MPH

Chances are you know someone who is allergic to peanuts, perhaps even someone in your family. And it’s no wonder, with the continuing rise in this very serious food allergy. Although the prevalence varies by worldwide geography and culture, as many as 8 percent of children and 2 percent of adults are affected in the United States. And the rate is rising. Between 1997 and 2002, the number of children with peanut allergy under age 5 doubled. So interest and concern is growing among teachers, daycare providers, health care professionals, and, of course, parents.

Which foods cause allergies?
Peanuts are one of the eight foods that cause 90 percent of all food-allergic reactions. The others are milk, egg, tree nut (pecan, cashew, etc.), fish, shellfish, soy, and wheat. For people with true food allergies, ingesting even a small amount of the food can be serious and even fatal.

Peanut allergies are some of the most severe, and because peanuts are so common in our food culture, the potential for accidental ingestion is high. Peanut allergy is responsible for more deaths than any other type of allergy. And unlike some other foods, only about 20 percent of children outgrow a peanut allergy. To complicate matters, many peanut-allergic people are also allergic to tree nuts and other legumes. (Peanuts are not true nuts but are legumes, related to lentils, peas and soy).

What causes peanut allergy?
Peanut allergy arises from both genetic and environmental factors. Like other allergies, a food allergy is more common when other family members have atopic disease, especially those with eczema and asthma. Studies of twins have found a strong genetic influence. But sometimes, there is no apparent family history. For peanut allergy to develop, there is an initial exposure that causes sensitization. Studies are unclear as to when this occurs. Some research has suggested that peanuts in the mother’s diet during pregnancy and breastfeeding plays a role. A recent European study linked expectant mothers’ consumption of nuts and peanuts with an increased risk of asthma in their children. However, other studies suggest that pregnant women who avoid eating peanuts can actually increase the chances of allergy in their children.

Peanut proteins do cross into breastmilk, although research has not shown a clear link between breastmilk exposure and peanut allergy in children. There is also evidence of cross-sensitivity to soy-based formulas. Other routes of exposure can include use of skin creams containing peanut oils. It isn’t clear if waiting until children are at least 2 or 3 years old before introducing peanuts and other allergenic foods can decrease the risk of allergy. Some experts believe this may actually increase a child’s risk for a food allergy, because it prevents the child from building up a natural tolerance to the food—an immune process that begins early in life.

What happens?
The first time a food is eaten, the allergic person’s immune system mistakenly sees the food as dangerous and creates specific antibodies to the food. When the food is eaten the next time, the immune system releases large amounts of chemical substances, including histamine, to protect the body. This triggers allergic symptoms throughout the body, in the respiratory system, gastrointestinal tract, skin, and even the cardiovascular system. This is called an anaphylactic reaction. Symptoms can include rash/hives, abdominal pain, mouth and throat swelling, wheezing, drop in blood pressure, and heart arrhythmias. This is an emergency and requires immediate medical treatment.

It is hard to predict each person’s sensitivity to peanuts. For most people, severe reactions can occur after ingesting even small amounts. For others, casual contact, such as touching contaminated tables or being in the same room with peanuts can cause symptoms. The US now has labeling laws for all commercially processed foods requiring manufacturers to disclose major food allergens. However, even if peanuts are not listed as a main ingredient, there are risks of contamination when labels state “may contain peanuts” or ‘‘made in a factory that also processes peanuts.’’

What can you do?
If you’re pregnant, talk with your physician about your family history of allergy and asthma. You may want to consider avoiding peanuts if your risks are high. Exclusive breastfeeding for at least 3 months helps protect against childhood wheezing and possibly the development of asthma. The American Academy of Pediatrics recommends continuing breastfeeding for at least the first year. Wait until your baby is at least 4 to 6 months old before introducing sold foods.

If you have a child with peanut allergy, become informed, and educate those who care for your child. Strict avoidance of foods that contain peanuts or peanut products is the only way to avoid a reaction. Reading ingredient labels for all foods is critical. And, since manufacturers frequently change processing, it’s important to read labels every time, even on tried and true products. Watch for risky situations (birthday parties, Asian and exotic foods), hidden ingredients, and cross-contamination (using the same utensil for multiple foods). You might want to consider a medical-alert bracelet for your child. Be prepared for an emergency. You’ll need to have on hand antihistamines such as Benadryl, and epinephrine, in injectable form such as EpiPen, and know how and when to use these.

For more information see:
Food Allergy & Anaphylaxis Network
American Academy of Allergy, Asthma & Immunology
American College of Allergy, Asthma & Immunology
Academy of Pediatrics

About the Author
Nancy is the founder of Marvelous Multiples and the mother of a peanut-allergic child. Her son (a fraternal twin) was diagnosed at one year of age, after a reaction to eating a tiny piece of peanut butter cracker. Interestingly, his twin sister has no allergies, and there is no known family history of food allergy. Her son is now 18 years old, and fortunately has never had a serious reaction. But Nancy cautions, “We have also been extremely vigilant about food and have been strong advocates in educating family, friends, and teachers.”

One of Tommy’s very first almost-sentences was at around 16 months: “Ecka, bloo, awoun, awoun.” (For those not fluent in Tommyese, that’s “The blue record is going around and around the turntable, mother.”)

Now just one month shy of 2, he’s more likely to say, “Thinking about Electric Light Orchestra. Play Kinks record! ‘Victoria! Victooooooooria!’ That record has a yellow label! Most records are black. No one’s in the record store. Van Halen! Van Halen record!”

And yes, he’s said all of those things in one breath before. On neighborhood walks, he’s been known to greet complete strangers with friendly declarations of, “Van Halen record!” He wants to share his Van Halen love with the world, I suppose, and bless him for it, as I think he’s pretty much alone in that mission.

Tommy spends a lot of his time thumbing through my husband’s massive record collection and selecting his favorites, sometimes based on the cover sleeve art, sometimes because he recognizes the logo of some obscure mid-80s Swedish metal band. And since we’ve temporarily banned TV (how’s that going, you ask? Delightfully well, actually!), it seems we spend even more time playing records.

Tommy listens to what we listen to. He knows classic children’s tunes that we dredge up from memory, but with the exception of a few well-worn gifts of lullaby records (and one novelty children’s CD featuring ridiculous songs about The Hulk that we couldn’t resist), we don’t own any music specifically recorded for children. Well, not modern music, anyway. We’re the proud owner of “TV Jamboree: 16 Great Songs from Ten Top Children’s Favorite Shows,” a record produced in 1958 by A.A. Records, Inc. If we ever need to hear music from Howdy Doody, Wagon Train or Rin-Tin-Tin, we’re set.

I don’t think Tommy is lacking. So he doesn’t know the Barney song about everyone loving each other. So he likes to sing along with The Ohio Express’ “Yummy Yummy Yummy I Got Love in My Tummy.” No real damage done, right?

I thought I’d share a few of Tommy’s frequent requests, in case you are buried beneath repeat listens of Barney songs and would like a change.

• The Kinks: “Victoria”

Tommy and I belt this out together at full volume. I think we should start a Kinks cover band.

• The Free Design: “Kites are Fun”

This song is unbelievably poppy and sweet, and is perfect for children. “See my kite, it’s fun. See my kite, it’s green and white! Laughing in its distant light!” Oh, OK.

• The Roches: “The Hammond Song”

The three sisters’ folksy harmonies are nothing short of glorious as they sing about lost opportunities and the problems of going back home. The words may be heavy, but the music is soaring, especially when accompanied by a toddler’s tiny voice.

• Electric Light Orchestra: “Yours Truly, 2095”

I enjoy the tortured angst of Jeff Lynn considering the robotic girlfriend he is forced to live with in the future while missing his true love stuck in 1981. Tommy just wants to dance.

• Krokus: “Our Love”

I’m not sure why he likes this so much. I think, honestly, it has something to do with the fact that the record’s vinyl is clear. He dances like a madman as soon as he hears those drums, though.

• Herb Alpert & The Tijuana Brass: “Spanish Flea”

Tommy has an abiding love for this song. At this point, I think it’s a spiritual thing. I used to sing it to him a lot, substituting the following lyrics: “You’ve got to chew, chew, chew your food. You’ve got to chew, chew, chew your fooooood…”

• Slayer: “Raining Blood”

The husband likes metal. The boy likes metal. It was in the stars.

The jury was out the last time US Preventive Services Task Force (USPSTF) considered the appropriateness of screening all newborns for hearing loss. The USPSTF concluded that there simply was not enough research available to determine whether they should recommend for or against such screening during the baby’s hospital stay after birth.

Well, that was 2001. Times marches on, research happens. Now, a group of Oregon-based researchers has assessed the research on this practice that has occurred in the intervening years. This time, the researchers agree: Enough data are available to make a recommendation.

What do they recommend?
In a study published in the July 2008 issue of Pediatrics, a research team led by Dr. Heidi D. Nelson determined that all newborns should be screened for detection of “moderate-to-severe permanent, bilateral congenital hearing loss.”

Why?
New studies have examined speech and language outcomes of children who were screened during their post-birth hospital stay, as well as those who were not. The meta-analysis of these studies conducted by Nelson and her colleagues shows:

• Children with hearing loss that was detected as part of the newborn screening protocol “have better language outcomes at school age” than their non-tested counterparts.

• Infants identified with hearing loss through the screening receive “referral, diagnosis and treatment” sooner than those whose hearing loss is identified in other ways.

• The clinical community has recognized the importance of early intervention; the findings of this study support such an approach.

Luckily, the Joint Committee on Infant Hearing (JCIH) has developed position papers and practice guidelines for early identification, intervention and follow-up care for infants and young children. So, it should be an easy thing for hospitals and birthing centers to implement this recommendation if they aren’t already doing so.

The bottom line
It may seem like there’s a heckuva lot that the health care professionals want to do with your baby in the hours after birth. It’s true, there are—and it can be exasperating. But this procedure has merit. If your baby’s hearing is fine, the only thing you lose is a little time. If it’s not, this screening might make a big difference in your baby’s communication ability. Seems worth it to me!

Summer is fading fast, and maybe that is why sunshine seems to be at the top of my mind. Whatever the reason, while today’s post offers another caution about the sun, it is relevant year-round.

What’s the problem?

You may think that if you follow recommendations for using sunscreen that you and your family will be safe from the sun. However, parents should be aware that the Food and Drug Administration (FDA) has identified many different medications that can cause what is called “photosensitivity.”

These medications may make people more susceptible to short-term or long-term “photosensitivity disorders,” including:

acute symptoms

• severe sunburn
• eye burn
• hives
• eczema-like rashes with itching, swelling, blistering, oozing, and scaling of the skin

chronic symptoms

• premature skin aging
• stronger allergic reactions
• cataracts
• blood vessel damage
• weakened immune system
• skin cancer

Such reactions can happen unexpectedly, even after only a brief time or when it is cloudy outside. Reactions are most common with sunlight, but they also occur from other sources of UV radiation, including tanning booths and purple-lighted bug zappers.

Not everyone who takes these medications will have a photosensitive reaction. And reactions may vary over time; for example, people who have a reaction after one use may not have a reaction after subsequent uses. That’s why it is especially important for parents to be aware of their children’s exposure to these agents.

What medications are high-risk?

It’s odd to think that the acne medication your teen wants to use to help her skin may end up causing it to be damaged by the sun—but there it is. Topical and oral medications, as well as acne facial washes can cause the user to be photosensitive. Read labels and watch out for:

• Tetracycline and Doxycycline
• Accutane or IsotretinoinRetinoids
• Salicyclic acid

Other medications that may cause reactions include:

• St. John’s wart
• Antihistamines
• Antibiotics
• Non-steroidal anti-inflammatory drugs (NSAIDs), like Motrin and Aleve
• Anti-depressants and antipsychotics
• Oral diabetes medications
• Tranquilizers
• Certain creams, lotions and other skin treatments

This list isn’t exhaustive. Your safest bet is to ask your physician and/or pharmacist about any medications that are prescribed for you or your child.

How can I protect my family?

Dr. Patrick Pasqualriello, Jr. of Children’s Hospital of Philadelphia and the FDA offer some helpful tips for preventing problems.

• Ask your doctor or pharmacist if photosensitivity is a known side effect of any medication before you give it to your child.
• Read the information packet you receive with your prescription—and read the labels of face washes before using them.
• Follow safe sun practices: Avoid sun during peak hours, limit sun exposure, use ample sunscreen, reapply sunscreen often, and consult the Environmental Working Group’s sunscreen database when you choose what product you’ll use for your family. (The FDA does note that titanium dioxide may be the most helpful.)
• Cover up! Choose clothes that cover a lot of skin, including a wide-brimmed hat.
• Be aware that sunscreen may not help, so keep an eye out for the symptoms listed above.

Most importantly, if you notice a reaction to the sun, contact your health care provider immediately. There may be treatment—or other prescription options—available.

credits: iStockphoto

Guilty as charged. That’s how I’d plead if you charged me with sometimes sending my kids out to play without sunscreen. “But, Your Honor,” (I’d argue in my own defense) “never during the peak hours!” and “There’s no family history of skin cancer!”

But I admit it. I do have a somewhat laissez-faire attitude about sunblock. I guess my approach has been influenced by two main concerns.

I’ve got questions
The first: if they are totally shielded, the children might become deficient in vitamin D. This danger has received a lot of media attention in recent years (See USA Today, Medfinds, and Natural News for just a taste or do a search on Google’s news listing). In a timely coincidence, I see that the National Institute of Health has issued a press release about the topic.)

The second: confusion about sunblock itself. What is in that oddball goop, anyway? What ought to be in it? Is a lotion or a spray better? If known-baddie aluminum has been so prevalent in sunblock, what other dangerous ingredients are there—and how do I avoid them?

Who has answers?
You’d think that the Food and Drug Administration (FDA) would have tight control on this issue, wouldn’t you? Actually, no. It wasn’t until just one year ago, in August 2007, that the FDA even proposed UVA standards for sunscreen, and those rules have not gone into effect. What’s more, they fall far short of the mandatory and comprehensive safety standards that many advocates call for.

Luckily, the Environmental Working Group (EWG) has taken on this issue. They can’t help with my first concern. (Perhaps I’ll need to follow up on that NIH press release for that.) But they’ve taken aim at my second concern. While they don’t set or enforce standards, they do call attention to concerns about sunscreen products and educate consumers.

For consumers who are concerned about sunscreen safety, the EWG’s new Shopper’s Guide to Safer Sunscreens is a great place to start.

EWG knows sunblock
In a study of almost 1,000 name-brand sunscreens, EWG found that 4 of 5 contain chemicals that “may pose health hazards” or “don’t adequately protect skin” from sun damage. The group ranks sunscreens into three categories (low hazard, moderate hazard, and high hazard) and assigns a numerical score of 0-10 to indicate level of risk.

The top offenders may surprise you, as they include popular brands like Coppertone, Banana Boat, and Neutrogenia. But what’s best about the site is that it is interactive. Click on over and select or type in your sunscreen brand to read EWG’s assessment of its flaws and/or merits. You just may be surprised.

EWG knows sun exposure
In addition to details about particular products, EWG provides a series of helpful tips for getting through the summer with lower risk that may remind you of the “Safe Sun” guidelines summarized on familydoctor.org or the recommendations of the World Health Organization (WHO) and others. Drawing on these resources, here’s what you need to know:

1. Protect kids! Keep in mind that too much sun puts children at risk for heat stroke and, later in life, skin cancer.
2. Protect babies! Keep babies younger than six months of age out of direct sunlight.
3. Avoid sunlight during peak hours. Some sources identify “peak hours” as noon to 2 p.m., while others (including EWG) say 10 a.m. to 4 p.m. Use your judgment, and be sure to consider the particular details of where you are, including altitude.
4. Use ample sunscreen. Apply your sunblock twenty to thirty minutes before you head outdoors, so that it can absorb into your skin before you’re exposed to the sun’s rays.
5. Reapply sunscreen often. Water will wash it off; the sun will break it down. The protection you start out with will degrade unless you reapply sunscreen as needed. The WHO recommends every 2 hours.
6. Avoid combination products. Skip products that promise built-in bug repellent. While it may seem convenient to only be applying one product, the required reapplications of sunscreen would expose you to higher levels of pesticide than necessary.
7. Wait on the bug spray. EWG encourages a 15-minute wait between applying sunscreen and bug spray, so that less of the pesticide is absorbed into the skin.
8. Buy new sunscreen each year. No one likes to be wasteful, but the active ingredients will degrade in the intervening year. For full protection, use a fresh product—and don’t forget to check EWG’s handy guide so you choose the one that’s safest for your family.

The EWG doesn’t address the vitamin D issue, but it does make me feel confident about my ability to choose a safe sunscreen for my family. I will be giving more thought to our sunblock practices during these last, hot weeks of summer!

As if U.S. women and babies are not subject to enough medical interventions during labor and delivery (take our national one-in-three c-section rate, for example), Barnev, Inc. brings us the BirthTrack System.

Here’s the product to show us exactly who is in the driver’s seat when it comes to your labor. And it’s not you, mamas. It’s not your babies, either.

No, indeed. Use the BirthTrack System during your labor, and you’ll have two monitors affixed to your cervix and a third fastened directly to your baby’s scalp. You’ll spend your labor lying in bed on your back while your health care providers watch the monitor to assess how much your cervix has dilated and how far your baby’s head has descended.

You may think that labor progresses best when you’re able to stay on your feet, move around, and let gravity help the baby descend in the birth canal. According to the prevailing wisdom and current research, you’d be right. (See articles by Di Franco et al, Romano et al, Shilling et al, Roberts and Hanson, and—perhaps my favorite—“No Routine Interventions” by Lothian et al, or do your own PubMed search.)

But don’t worry! That’s just what the BirthTrack System is designed to address: “non-progressive labor.” This system will make it even easier for your doctor to decide that it is time for him to administer the next medical intervention. Especially since, with you on your back, the progress of your labor is likely to be slower. Just relax and go along with it, honey. Feel good that, according to Barnev’s site, “earlier management is likely to result in earlier recognition of a need for CS.”

And hey, at least your partner can now “be an active participant in the labor process,” too! How? By “follow[ing] the progress of the partogram on the screen next to your bed.” Isn’t that reassuring? I’m not sure how the partners who have held, rubbed, swayed with, massaged, encouraged, and otherwise supported their partners during labor might think this compares. Let’s hope they think it is a bum situation.

Now, I am not a doctor or even a nurse. I have given birth three times, and I have had three very different birthing experiences. I do suppose that the BirthTrack System might be helpful in rare cases during at-risk deliveries that need more monitoring.

However, the people of Barnev are not suggesting their device be used just during at-risk labors. No, they’re recommending it for all mothers-to-be and physicians, during all labors. So that you can avoid the “usual procedure [sic] vaginal examinations” that “are performed numerous times during labor,” they want you to agree to submit to being hooked up to their invasive monitoring system. Does that make any sense to you?

Here’s something else that might give you pause: Barnev’s Medical Advisory Board is, as of this writing, unnamed on its web site. It’s four-member Board of Directors includes just one physician, Dr. Dalia Megiddo, and her focus is reported to be “life science investments.” One can imagine that it didn’t take long for Israel-based Dr. Megiddo and her Israeli and German colleagues to conclude that yet another device for labor intervention could be a hot commodity in the U.S. market.

A parting thought
Doesn’t this image of a woman connected to the BirthTrack System look just a bit like this image of a woman in a reproductive farm from Battlestar Galactica?

If you’re a new or expectant parent—or if you know someone who is—here’s a word to file in the back of your mind: ankyloglossia. Also known as “tongue-tie, ankyloglossia is the medical term used when the tissue that connects the tongue to the floor of the mouth (a.k.a. lingual frenulum) is short.

“Tongue-tie” may sound cute, but it’s not. Although cases vary from mild to severe, ankyloglossia can cause a host of breastfeeding problems, including:

• slow (or no) weight gain
• poor seal of mouth on the breast
• clicking sound, with maternal nipple pain
• failure of tongue to extend during feeding
• continuous sore nipples (in spite of good latch and position technique)
• increase in pain during the feeding

But here’s something else to file in the back of your mind: tongue-tie can be treated. In a recent study, all of the mother-infant dyads experienced significant improvement in breastfeeding after a simple procedure known as tongue-clipping (a.k.a. frenulotomy).

Methods
In this study, Donna Geddes, PhD and her team of researchers in Perth, Australia sought to determine changes in breastfeeding, including sucking characteristics, following frenulotomy.

Health care providers referred 24 mothers of healthy, term infants to participate in these studies. These mother-infant pairs had on-going breastfeeding problems even though they had received lactation advice and follow-up. The infants were between 4 and 131 days old at the time of the study (mean = 33 days).

The researchers used ultrasound, a breastfeeding assessment known as LATCH, reports of pain, and calculations of milk intake.

• Ultrasounds of the infants’ oral cavity were taken before and after the frenulotomy.

• LATCH is a point-based scoring system that enables the observer to rate five characteristics during a breastfeeding session: latch, audible swallowing, type of nipple,  level of comfort, and hold (positioning).

• Pain was assessed by the mother on a 0 to 10 scale.

• Milk intake was measured by weighing the babies before and after feedings.

Researchers also wanted to assess milk production through collection of test weights before and after feedings for 24-hours before the procedure and 24-hours after. However, only a small number of mothers (8 before and 6 after) were willing to provide this data. Understandably, most did not want to delay resolving their breastfeeding problems!

Frenulotomies were performed by a pediatric surgeon with the assistance of a lactation consultant. Breastfeeding was encouraged immediately afterwards.

Results
No babies experienced complications from the frenulotomies. Although most did cry immediately after the procedure, mothers were encouraged to breastfeed immediately and that seemed to end their distress.

The researchers reported improvement on all indicators following the tongue-clipping. Milk transfer, milk intake, and LATCH scores were up; reports of maternal pain were down. In addition, for those mothers who did provide 24-hour milk production data, milk production was greatly increased.

Conclusion
Perceptions of low milk production and nipple pain during breastfeeding are leading reasons why women say they quit breastfeeding. Who wouldn’t think of quitting if they worried about their babies’ weight or experienced pain every time they put their babies to breast?

While there are certainly other causes of breastfeeding problems, it is exciting to think that a simple, quick medical procedure may help solve both of these problems for many mothers and babies! If only health care providers think to look for the culprit under the baby’s tongue … and parents think to ask them to do so!

Parents, don’t be “tongue-tied.” If you experience these problems, speak up.

If you are concerned about the safety of vaccines, you won’t want to miss, “Do Vaccines Cause That?“

Written by Martin G. Myers, MD and Diego Pineda, MS, recognized immunization experts, “Do Vaccines Cause That?” is a clear and comprehensive discussion of the concerns related to vaccine safety.

Myers and Pineda, colleagues at the National Network for Immunization Information (NNii), have co-authored more than 80 peer-reviewed articles on vaccines. Dr. Myers is the former director of the National Vaccine Program Office and is a professor in the Departments of Pediatrics and Preventive Medicine and Community Health at the University of Texas Medical Branch at Galveston, Texas.

“Do Vaccines Cause That?” is divided into two sections. The first section focuses on side effects, risks, cause versus coincidence and reliable information sources. The second half is devoted to specific vaccine safety concerns, such as autism, asthma, immune disorders, SIDS, birth defects and cancer.

The take home message for parents: Know your facts before you act.